May 2019 Hot Topics

Clinical Decision Making: Turning the Illogical to the Logical (or the Logical to…)

Dr. Ian Scott

Date: Tuesday, May 28, 2019

Time: 12:00pm to 1:30pm


  • LSC 1312 (host venue)
  • DHCC 2262
  • CWH SHY E404
  • NHSC 9-374
  • RJH CA 011

Remote Access: Additional access options are available. Please email to request remote access.

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  1. Describe some of the foundational evidence related to clinical decision making
  2. Describe the controversies in clinical decision making teaching
  3. Describe an evidence based approach to teaching clinical decision making


Clinical decision making research over the past 40 years has entailed a quest to find the underlying method by which experts solve problems so that this method could be taught to learners. This quest has been disappointing as no such universal method has been discovered.

Currently, the dual process framework is the dominant model used to understand how clinical decision making occurs. In this model, diagnoses are conceived to arise in one of two ways:

  • by a fast, unconscious, retrieval process (System 1)
  • or a more analytical, slow, deliberate, and conscious logical process (System 2)

Arising from this model are two conceptions of how we should be teaching clinical reasoning:

  1. Support students developing an appropriate range of diagnostic “memories” so they can recognize (system 1) the same or similar diagnoses in the future
  2. Support students developing strong analytic reasoning as well as helping them guard against system 1 “biases” so they can logically derive (system 2) diagnoses in the future

Recent clinical decision making research has pointed to a third way which supports the importance of both system 1 and system 2 processes in making clinical diagnoses. In this Hot Topics session, practical applications of the literature will be shared that will assist teachers and learners in developing an approach to clinical decision making.

Accredited by UBC CPD



The University of British Columbia Division of Continuing Professional Development (UBC CPD) is fully accredited by the Committee on Accreditation of Continuing Medical Education (CACME) to provide study credits for continuing medical education for physicians. This program meets the certification criteria of the College of Family Physicians of Canada and has been certified by UBC CPD for up to 20 (1.5 per session) Mainpro+ Group Learning credits. Each physician should claim only those credits he/she actually spent in the activity.

RCPSC Accreditation

Hot Topics in Health Professions Education is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.